Victor Dominocielo: Let’s Bring Back Bloodletting!

The great granddaddy of all medical techniques and treatments is bloodletting. It is the longest running and most widespread medical technique in all of recorded history.

Origins of the technique are attributed to the ancient Egyptians of about 3,000 years ago when it was used to remove evil spirits that caused disease. Some websites suggest that it may have originated in ancient Indian Ayurvedic medicine from around the same time period. Over the last 3,000 years, bloodletting spread from Egypt to India, the Far East, Greece and through the Roman Empire to most Mediterranean cultures.

There are two questions that this incredibly prolific procedure brings immediately to mind: How and why did this supposed medical technique captivate and fool the best and the brightest minds of so many civilizations over such a long period of time, and why was it abandoned? Answering these questions will provide important insight into how each new generation understands its relationship to disease and individuals’ proclivity to fool oneself in regards to medical procedures.

As a group, humans are renowned for making medical mistakes. Many civilizations perpetrated the erroneous ideas of the Egyptians, then the Greeks and Romans for over 3,000 years. The “theories” of Spontaneous Generation (life from non-life) and the Four Humors (fluids in the body had to be balanced — the basis for bloodletting) continued until the 1870s!

George Washington, who had access to the best medical care of his day, bled to death in 1799 in response to a cold, developing pneumonia and a swollen throat. Louis Pasteur and others finally proved that Spontaneous Generation did not exist around the 1860s and that disease was caused by germs, not by an imbalance of bodily fluids. As this Germ Theory of Disease became widely understood and accepted by the medical profession, bloodletting gradually fell out of favor in the late 1800s and was finally discontinued by a very embarrassed medical profession.

In addition, the medical profession realized that in hindsight, bloodletting violated the Hippocratic Oath (“First, do no harm”) by actually first harming the patient and then hoping that the body would rally against the harmful insult it received. So the two reasons above — the widespread acceptance of the germ theory of disease, and the realization that bloodletting violated the Hippocratic Oath — are the reasons why bloodletting stopped.

The next question is, “Why did bloodletting persist so long?” If we asked practitioners of bloodletting to explain their rationale, legitimacy and beneficial results, they would have said that bleeding “is a renowned and ancient medical practice that has been improving health for thousands of years.” The most confounding and amazing thing about bleeding is that it did convince the best and brightest minds of many generations and different civilizations that, “It works.”

No matter what your complaint of pain, stress or illness, the drama of watching your life’s blood stream out of your body caused a significant distraction from your medical condition and a significant placebo effect. Patients and the “physicians” of the time were convinced of bleeding’s benefits. How many alternative medical treatments today (homeopathy, aroma therapy reflexology, etc.) use the same argument of “It works” even though there is no scientific evidence of any benefit other than the placebo effect?

Today we scoff at this misguided idea of bleeding, which lacked any evidence and was perpetuated through the millennia by the patient-generated placebo process. Yet we turn around and so easily become enamored of foreign folk medicine practices, like acupuncture, whose legitimacy is explained by stating that it “is a renowned and ancient medical practice that has been improving health for thousands of years” despite using the same basic technology as voodoo in the pursuit of invisible “chi” and the balancing of yin/yang “forces” along invisible “meridians” in our bodies.

So, let’s bring back bloodletting! It produces a slam/bang placebo effect: There is absolutely nothing that dramatizes and distracts a patient from whatever ails them more than watching their life’s blood stream out of their body. With today’s knowledge of wound cleaning and suture repair, we could keep down the infection rate and charge buckets of money for the drama.

Forget those minor placebo therapies like cranial massage, iridology, aroma therapy and bio-field realignment — bloodletting is a real winner! Forget those moral issues about first harming the patient, charging patients for their own patient-generated placebo effect and deceiving patients with magical explanations about invisible body parts and vibrational forces. Bloodletting is a real winner!

If Eastern, Western and other cultures can pursue and perpetuate medical nonsense for millennia, how do we go about making better decisions for our health?

The development of a formalized process to negate the distorting effects of human belief, emotion and wishful thinking in the pursuit of accurate evidence was needed by the different cultures of our civilization. In order for this process to self-correct for the inevitable mistakes that would occur, it had to be based on the simple biology of how all mammals learn — mimicry and repetition over time. Thousands of years of trial and error gradually pointed toward a pattern for success: random subjects, double-blinded experimenters and placebo control groups performing carefully measured experiments, which are repeated over time by different groups in different places and under constant review by peers, yielded stable evidence from which an accurate body of knowledge was built.

Most all fields of study at universities throughout the world use this same basic scientific methodology. The resultant science-based medicine is a worldwide standard. In order for any medical procedure or drug to become part of science-based medicine, only one simple and straightforward criterion must be met: The procedure or drug must significantly beat the placebo effect.

If you have questions about any medical remedies or procedures, look them up on Skepdic.com (the Skeptic’s Dictionary) and Sciencebasedmedicine.org. You’ll find out their history, development and whether or not they can beat the placebo effect.

— Victor Dominocielo, a California-credentialed teacher for 36 years, is the human biology and health teacher at a local middle school. The opinions expressed are his own.

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